- Professional overview
Since the 1990s, Dr. Van Devanter has conducted behavioral intervention research integrating a community based participatory research approach into the development and testing of theory-driven interventions to promote health and reduce disease in populations with significant health disparities in HIV, STDs and tobacco related disease. She has also worked in close collaboration with state and local health departments to develop programs improve community level health and public health practice. Since coming to NYU she has been involved in numerous interdisciplinary collaborative studies with the NYU School of Medicine, Dentistry, and Public Health Program.
DrPH, 1992, Columbia University School of Public HealthMPH, 1985, Harvard School of Public HealthEdM, 1975, Boston UniversityBS, 1974, Boston UniversityDiploma, 1964, St Agnes School of Nursing
- Honors and awards
Fellow, American Academy of Nursing (2011)Fellow, New York Academy of Medicine (2011)Public Health Achievement Award, New York City Department of Health/ Mailman School of Public Health, Columbia University (1999)Fellowship in STD Prevention Association of Teachers of Preventive Medicine, Centers for Disease Control and Prevention (1999)Commendation, Office the Secretary, US Department of Health and Human Services for contribution to the National AIDS Education Prevention Program (1998)
- Professional membership
American Nurses AssociationAmerican Public Health AssociationAmerican Sociological AssociationCouncil for the Advancement of Nursing SciencePublic Health Association of New York City
A Qualitative Study of Patients' Attitudes toward HIV Testing in the Dental Setting.VanDevanter, N., Combellick, J., Hutchinson, M. K., Phelan, J., Malamud, D., & Shelley, D. (2012). Nursing research and practice 2012, (803169). 10.1155/2012/803169
An estimated 1.1 million people in the USA are living with HIV/AIDS. Nearly 200,000 of these individuals do not know that they are infected. In 2006, the CDC recommended that all healthcare providers routinely offer HIV screening to adolescent and adult patients. Nurse-dentist collaborations present unique opportunities to provide rapid oral HIV screening to patients in dental clinic settings and reach the many adults who lack primary medical providers. However, little is known about the feasibility and acceptability of this type of innovative practice. Thus, elicitation research was undertaken with dental providers, students, and patients. This paper reports the results of qualitative interviews with 19 adults attending a university-based dental clinic in New York City. Overall, patients held very positive attitudes and beliefs toward HIV screening in dental sites and identified important factors that should be incorporated into the design of nurse-dentist collaborative HIV screening programs.
Evaluation of Community–Academic Partnership Functioning: Center for the Elimination of Hepatitis B Health DisparitiesVanDevanter, N., Kwon, S., Sim, S., Chun, K., B Free CEED Coalition, & Trinh-Shevrin, C. (2012). Progress in Community Health Partnerships: Research, Education, and Action 5, (219-219). 10.1353/cpr.2011.0043 Johns Hopkins University Press.
Feasibility of implementing rapid oral fluid HIV testing in an urban University Dental Clinic: a qualitative study.Hutchinson, M. K., VanDevanter, N., Phelan, J., Malamud, D., Vernillo, A., Combellick, J., & Shelley, D. (2012). BMC oral health 12, (11). 10.1186/1472-6831-12-11
More than 1 million individuals in the U.S. are infected with HIV; approximately 20% of whom do not know they are infected. Early diagnosis of HIV infection results in earlier access to treatment and reductions in HIV transmission. In 2006, the CDC recommended that health care providers offer routine HIV screening to all adolescent and adult patients, regardless of community seroprevalence or patient lifestyle. Dental providers are uniquely positioned to implement these recommendations using rapid oral fluid HIV screening technology. However, thus far, uptake into dental practice has been very limited.
Oral health care and smoking cessation practices of interprofessional home care providers for their patients with HIV.VanDevanter, N., Dorsen, C. G., Messeri, P., Shelley, D., & Person, A. (2012). Journal of interprofessional care 26, (339-40). 10.3109/13561820.2012.676107
The need for oral health services among patients with HIV, especially those in advanced stages of disease and those who smoke, has been well documented. Patients receiving HIV-related home care services provide an opportunity for assessment of oral health and smoking cessation needs; however, the majority of home care providers lack formal training to provide these services, thus interprofessional collaborations may be of value. This study assessed the oral health and smoking cessation practices of a random sample of 81 HIV home care providers. Results showed very favorable attitudes toward providing these services with some differences across disciplines. More than 70% of nurses would like to receive additional training in comprehensive oral health assessment by dental professionals. The study provides evidence for the potential of expanding these services for patients with HIV through interprofessional collaboration, in particular with nurses and dentists.
The influence of substance use, social sexual environment, psychosocial factors, and partner characteristics on high-risk sexual behavior among young Black and Latino men who have sex with men living with HIV: A qualitative study.VanDevanter, N., Duncan, A., Burrell-Piggott, T., Bleakley, A., Birnbaum, J., Siegel, K., … Ramjohn, D. (2011). AIDS patient care and STDs 25, (113-21). 10.1089/apc.2010.0100
Understanding the sexual risk behaviors of youths living with HIV/AIDS is critical to secondary prevention of HIV. As part of a larger qualitative study of youths living with HIV, in-depth interviews were conducted with 27 African American and Latino, HIV-infected young men who have sex with men, aged 16-24 years, living in New York City. The study explored the role of substance use, the social-sexual-environmental, and psychological contexts in which sexual risk behaviors occurred. Since learning of their HIV infection, the majority of participants had reduced their risky sexual behaviors; however, a subset (26%) of participants continued to have unprotected sex, in most cases with multiple partners. Substance use, the social environmental context of the sexual encounter, the psychological impact of HIV on sexual behavior, and partner characteristics were associated with high-risk sexual behaviors in this group. Among high-risk participants, factors associated with risky sexual behaviors clustered, with 57% reporting two or more factors. More intensive interventions are needed for this subset of youths living with HIV, including assessment and treatment for substance use and mental health issues, strategies for stress reduction, and partner interventions.
Gender, sexual orientation, and adolescent HIV testing: a qualitative analysis.Siegel, K., Lekas, H. M., Olson, K., & VanDevanter, N. (2010). The Journal of the Association of Nurses in AIDS Care : JANAC 21, (314-26). 10.1016/j.jana.2009.12.008 Elsevier BV.
Using qualitative data, this article explored the circumstances leading to HIV testing among 59 HIV-infected adolescents recruited from New York City HIV clinics. Results showed differences between the heterosexual women and the gay and bisexual men. Most of the young women were tested during routine health care or self-initiated tests, and most were asymptomatic when they tested positive. Their testing decisions were sometimes based on assessments of their boyfriends' risk behaviors rather than their own. Many young men were experiencing symptoms of illness when they tested positive, and about half of them recognized their symptoms as related to HIV and sought tests. Some young men expressed fear of learning about positive test results, which delayed their testing, and some providers did not initially recommend HIV testing for young men who presented with symptoms. The article concludes that consideration of these gender and sexual orientation-related concerns can facilitate HIV testing among adolescents.
Adherence to antiretroviral therapy among older children and adolescents with HIV: a qualitative study of psychosocial contexts.Merzel, C., VanDevanter, N., & Irvine, M. (2008). AIDS patient care and STDs 22, (977-87). 10.1089/apc.2008.0048
Abstract Survival among perinatally infected children and youth with HIV has been greatly extended since the advent of highly active antiretroviral therapies. Yet, adherence to HIV medication regimens is suboptimal and decreases as children reach adolescence. This paper reports on a qualitative study examining psychosocial factors associated with adherence among perinatally infected youth ages 10-16 years. The study was based on in-depth interviews with a sample of 30 caregivers participating in a comprehensive health care program in New York City serving families with HIV. A subsample comprising 14 caregivers of children ages 10 and above is the focus of this paper. The analysis identified a number of themes associated with the psychosocial context of managing adherence among older children. Maintaining adherence was an ongoing challenge and strategies evolved as children matured. Regimen fatigue and resistance to taking the medications were major challenges to maintaining adherence among the oldest children. In other cases, caregivers developed a kind of partnership with their child for administering the medications. Disclosure to the child of his or her HIV status was used as a strategy to promote adherence but seemed to be effective only under certain circumstances. Social support appeared to have an indirect influence on adherence, primarily by providing caregivers with temporary help when needed. Health care professionals were an important source of disclosure and adherence support for parents. The study illustrates the interplay of maturational issues with other contextual psychosocial factors as influences on adherence among older children and adolescents.
Computer Access and Internet Use Among Urban YouthsBleakley, A., Merzel, C.R., VanDevanter, N.L., & Messeri, P. (2008). American Journal of Public Health 94, (744-746). 10.2105/ajph.94.5.744 American Public Health Association.
Making the connections: community capacity for tobacco control in an urban African American community.Merzel, C., Moon-Howard, J., Dickerson, D., Ramjohn, D., & VanDevanter, N. (2008). American journal of community psychology 41, (74-88). 10.1007/s10464-007-9155-7
Developing community capacity to improve health is a cornerstone of community-based public health. The concept of community capacity reflects numerous facets and dimensions of community life and can have different meanings in different contexts. This paper explores how members of one community identify and interpret key aspects of their community's capacity to limit the availability and use of tobacco products. Particular attention is given to examining the interrelationship between various dimensions of community capacity in order to better understand the processes by which communities are able to mobilize for social change. The study is based on qualitative analysis of 19 in-depth interviews with key informants representing a variety of community sectors in Harlem, New York City. Findings indicate that the community is viewed as rich in human and social resources. A strong sense of community identity and connectedness underlies this reserve and serves as a catalyst for action.
The $5 man: the underground economic response to a large cigarette tax increase in New York City.Shelley, D., Cantrell, M. J., Moon-Howard, J., Ramjohn, D. Q., & VanDevanter, N. (2007). American journal of public health 97, (1483-8). 10.2105/AJPH.2005.079921 American Public Health Association.
We examined the mechanisms by which living in a disadvantaged minority community influences smoking and illegal cigarette sale and purchasing behaviors after a large cigarette tax increase.
A community-based intervention designed to increase preventive health care seeking among adolescents: the Gonorrhea Community Action Project.VanDevanter, N. L., Messeri, P., Middlestadt, S. E., Bleakley, A., Merzel, C. R., Hogben, M., … St Lawrence, J. S. (2005). American journal of public health 95, (331-7). 10.2105/AJPH.2003.028357
We evaluated the effectiveness of an intervention designed to increase preventive health care seeking among adolescents.
Attitudinal and contextual factors associated with discussion of sexual issues during adolescent health visits.Merzel, C. R., VanDevanter, N. L., Middlestadt, S., Bleakley, A., Ledsky, R., & Messeri, P. A. (2004). The Journal of adolescent health : official publication of the Society for Adolescent Medicine 35, (108-15). 10.1016/j.jadohealth.2003.09.011
To examine attitudinal and contextual factors associated with the occurrence of sexual health assessments during adolescent primary care visits.
Factors Influencing Participation in Weekly Support Groups Among Women Completing an HIV/STD Intervention ProgramVanDevanter, N., Parikh, N.S., Cohall, R.M., Merzel, C., Faber, N., Litwak, E., … Greenberg, J. (2004). Women & Health 30, (15-34). 10.1300/j013v30n01_02 Informa UK Limited.
The role of social and behavioral science in public health practice: a study of the New York City Department of Health.VanDevanter, N., Shinn, M., Niang, K. T., Bleakley, A., Perl, S., & Cohen, N. (2003). Journal of urban health : bulletin of the New York Academy of Medicine 80, (625-34). 10.1093/jurban/jtg069
Studies over the last decade have demonstrated the effectiveness of public health interventions based on social and behavioral science theory for many health problems. Little is known about the extent to which health departments are currently utilizing these theories. This study assesses the application of social and behavioral science to programs in the New York City Department of Health (NYCDOH). Structured open-ended interviews were conducted with executive and program management staff of the health department. Respondents were asked about the application of social and behavioral sciences within their programs, and about the benefits and barriers to increasing the use of such approaches. Themes related to the aims of the study were identified, a detailed coding manual developed, narrative data were coded independently by two investigators (kappa.85), and data analyzed. Interviews were conducted with 61 eligible individuals (response rate 88%). The most common applications of social and behavioral science were individual-level behavior change to prevent HIV transmission and community-level interventions utilizing community organizing models and/or media interventions for health promotion and disease prevention. There are generally positive attitudes about the benefits of utilizing these sciences; however, there are also reservations about expanded use because of resource constraints. While NYCDOH has successfully applied social and behavioral sciences in some areas of practice, many areas use them minimally or not at all. Increasing use will require additional resources. Partnerships with academic institutions can bring additional social and behavioral science resources to health departments and benefit researchers understanding of the health department environment.
Developing a collaborative community, academic, health department partnership for STD prevention: the Gonorrhea Community Action Project in Harlem.VanDevanter, N., Hennessy, M., Howard, J. M., Bleakley, A., Peake, M., Millet, S., … Fullilove, R. (2002). Journal of public health management and practice : JPHMP 8, (62-8).
Community interventions are rare in the field of sexually transmitted disease (STD) control and prevention. The goals of the Gonorrhea Community Action Project are to design and implement interventions for the reduction of gonorrhea in high-prevalence areas and to increase the appropriateness and effectiveness of STD care in the participating formative research and developing the interventions was the creation of a community-academic-health department collaborative partnership. Using a staged model, this article presents a case study of collaboration development in the community of Harlem, New York.
Arithmetic versus harmonic mean values for cyclosporin-A pharmacokinetic parameters.Lum, B. L., Tam, J., Kaubisch, S., & Flechner, S. M. (1992). Journal of clinical pharmacology 32, (911-4).
The harmonic and arithmetic mean values for volume of distribution at steady state, half-life, and clearance of intravenous cyclosporin-A were calculated using an index set of 22 renal transplant candidates to determine if harmonic mean values provide a less biased estimate of central tendency than arithmetic mean values. Cyclosporin-A was measured using a nonspecific radioimmune assay method. The arithmetic mean value for volume of distribution was 16% larger than calculations by the harmonic mean method. Similarly, the arithmetic mean half-life and clearance values were larger than harmonic mean values by 10% and 15%, respectively. However, 95% confidence intervals for these pharmacokinetic parameters overlapped. When these mean pharmacokinetic parameter values were used to predict actual values in a test group of 22 renal transplant candidates receiving cyclosporin-A, similar levels of precision were demonstrated by either method. Both methods produced positively biased predictions for volume of distribution and clearance. However, these differences were not significant. These findings suggest there is little practical value for the use of harmonic mean calculations to describe the central tendency of pharmacokinetic parameters of cyclosporin-A under the conditions studied. The value of harmonic mean values for pharmacokinetic parameters in other patient populations or with other assay methods for cyclosporin remain to be studied.
Emergency response and public health in Hurricane Katrina: what does it mean to be a public health emergency responder?VanDevanter, N., Leviss, P., Abramson, D., Howard, J. M., & Honoré, P. A. Journal of public health management and practice : JPHMP 16, (E16-25). 10.1097/PHH.0b013e3181d8bbb2
Since 9/11, federal funds directed toward public health departments for training in disaster preparedness have dramatically increased, resulting in changing expectations of public health workers' roles in emergency response. This article explores the public health emergency responder role through data collected as part of an oral history conducted with the 3 health departments that responded to Hurricane Katrina in Mississippi and Louisiana. The data reveals a significant change in public health emergency response capacity as a result of federal funding. The role is still evolving, and many challenges remain, in particular, a clear articulation of the public health role in emergency response, the integration of the public health and emergency responder cultures, identification of the scope of training needs and strategies to maintain new public health emergency response skills, and closer collaboration with emergency response agencies.